QUESTION 1 Hawa is a 26-year-old female patient with a history of infertility. S

Question

QUESTION 1

Hawa is a 26-year-old female patient with a history of infertility. She and her partner have been trying to conceive naturally for 2 years. Hawa started taking fertility medication 6 months ago to stimulate follicle development. At 21 years of age, she was diagnosed with pelvic inflammatory disease, which was treated with antibiotics. Her menstrual cycle has been unpredictable over the last 3 months, with sporadic light bleeding. During the last month, she has felt nauseous and experienced diarrhea. Yesterday, she had a sudden onset of abdominal and pelvic pain and heavy vaginal bleeding. She is concerned about the sudden change and sees her gynecologist the following day.

QUESTION 1

a)A transvaginal ultrasound is used to confirm Hawa’s tubal pregnancy. Which of the following statements is true?

b)Hawa likely became pregnant 6 months ago and was not aware of the pregnancy until now.

c)Hawa’s will be allowed to continue her pregnancy, as long as there is no further vaginal bleeding.

d)If Hawa’s pregnancy continues, her life could be at risk.

e)Hawa’s pregnancy will likely be treated by total hysterectomy.

QUESTION 2

If Hawa’s pregnancy is determined to be only a few weeks along, which of these treatments would be her best option?

a)Injection of methotrexate

b)Injection of human chorionic gonadotropin

c)Partial hysterectomy

d)Dilation and curettage

QUESTION 4

If Hawa’s diagnostic ultrasound estimates that her pregnancy is about 4 weeks along, which of the following is true of the fetus?

a)Limb buds are well-developed.

b)Heartbeat is present.

c)Liver is producing bile.

d)Urine is produced.

QUESTION 5

If Hawa’s diagnostic ultrasound estimates that her pregnancy is about 8 weeks along, which of the following is true of the fetus?

a)Lungs are fully developed.

b)Bones have begun to calcify.

c)Limb buds have yet to form.

d)Sex is distinguishable.

Explanation / Answer

Ans 1)

If Hawa’s pregnancy continues, her life could be at risk

As per the symptoms like heavy bleeding, light spotting, diarrhea, nausea etc. it is most likely that Hawa has an ectopic pregnancy. The transvaginal ultrasound is a way to diagnosis ectopic pregnancy. It is not safe for the mother and the embryo is not able to develop as it is outside the uterus. It is important to remove the embryo immediately.

Ans 2) a) Injection of Methotrexate

If it is only one week and there are no immediate complications, medications can help. This can keep the ectopic mass from bursting inside and methotrexate is the most common for the same. This drug prevents the cells from rapidly dividing and will lead to miscarriage.

Ans 4) c) Hearbeat is present

If the pregnancy is 4 weeks long, it is enough to develop a heartbeat. Generally it starts to develop within 3 weeks and it is very faint.

Ans 5)

Sex is distinguishable

The sex is distinguishable during the 8 weeks mostly as the gonads start to slowly develop. It is not always the case but in most cases it is identiable.

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